Advanced PCa is Rare in Statin Users

A longer use of the medications lowers the risk of advanced prostate cancer, study finds.

Statin use is associated with a reduced risk of advanced prostate cancer, according to a study.

Researchers identified 2,579 prostate cancer cases—316 advanced—among 34,989 participants in the Health Professionals Follow-up Study who were free of cancer in 1990 and were then tracked until 2002. Current statin users and non-users had age-standardized incidence rates of advanced prostate cancer of 38 and 89 per 100,000 person-years, respectively.

Compared with men who were not using statins, those who were currently taking the drugs had a 49% reduced risk of any form of advanced prostate cancer and a 61% reduced risk of metastatic or fatal disease after adjusting for multiple variables, according to a report in the Journal of the National Cancer Institute (2006;98:1819-1825).

After adjusting for PSA screening history, current statin use was associated with a 43% and 65% reduced risk of advanced disease and metastatic or fatal disease, respectively. In addition, the longer men used statins, the lower their risk of advanced disease compared with men who never used the medications. Those who used the drugs for less than five years had a 40% reduced risk and those who used the drugs for five or more years had a 74% lower risk.

The investigators, led by Elizabeth A. Platz, ScD, MPH, of the Johns Hopkins Bloomberg School of Public Health in Baltimore, observed no association between statin use and total prostate cancer.

She and her colleagues evaluated the association between statins and prostate cancer because the drugs influence a number of pathways that potentially could be involved in cancer development, growth, and metastasis. In particular, statins inhibit 3-hydroxy-3-methylglutaryl (HMG) coenzyme A reductase, which catalyzes conversion of HMG coenzyme A to mevalonate, the rate-limiting step in cholesterol biosynthesis.

“The reduced availability of cholesterol for incorporation into the cell membrane could influence membrane-associated signaling that promotes cancer cell survival, such as Akt signaling in prostate cancer cells,” the authors explained.

Despite the new findings, “it is premature to recommend the use of statins for the prevention of advanced prostate cancer,” Dr. Platz said. “Further work is needed to address the role of PSA screening as a possible explanation for these findings, and to identify the biologic mechanisms that may underlie the inverse association, if this association is indeed causal.”